PB1956: ANALYSIS OF CLINICAL COURSE IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA AND COMPLEX KARYOTYPE – SINGLE CENTRE EXPERIENCE
Authors: Sofija Sarac, Vojin Vukovic, Darko Antic, Vladimir Otasevic, Biljana Mihaljevic, Andrej Pešić, Jelena Ivanović
Journal: HemaSphere (2023)

Topic: 6. Chronic lymphocytic leukemia and related disorders - Clinical Background: Chronic lymphocytic leukemia (CLL) is a genetically heterogeneous disease in which chromosomal and genomic aberrations are found in more than 80% of patients. The complex karyotype (CK) in CLL is defined as the presence of ≥3 structural or numerical aberrations in the same clone of CLL malignant cell. Aims: The aim of this study was the analysis of the clinical course in patients with CLL and CK, having in mind that CK represents one of the negative prognostic parameters. Methods: Retrospective cohort study included 185 patients from the Clinic of Hematology, Clinical Center of Serbia, with CLL diagnosis and for which conventional cytogenetics analysis has been performed. The patients were divided in 3 groups: group 1 - patients without chromosomal aberrations, group 2 - patients with 1 and 2 chromosomal aberrations and group 3 - patients with ≥ 3 chromosomal aberrations. The demographical data, clinical and laboratory parameters, therapy free survival and overall survival among the groups of patients were analyzed. Results: The study included 185 patients of which 114 were male (61.62%) and 71 were female (38.38%). The average age at diagnosis was 61.2±9.9. Group 1 consisted of 61 (32.27%), group 2 of 75 (40.54%) and group 3 of 49 (26.49%) patients. The patients in group 2 were statistically significantly (p<0.006) older at diagnosis (63.16±7.98) than the patients in group 1 (58.48±11.53). In the group of patients with CLL and CK, in comparison with other two groups at diagnosis, peripheral lymphadenopathy (73.5% vs. 50% and 64.4%, p<0.037) and intra-abdominal lymphadenopathy (53.1% vs. 16.7% and 24.7% p<0.001) were more commonly found. In addition, the diameter of the largest lymph node was found to be the biggest in the group with CK (38.5mm vs. 25mm and 30mm, p<0.01). Laboratory parameters in patients with CLL did not show statistically a significant relationship with the number of aberrations. The deletion of 17p in FISH analysis was more frequently found in the group with CK (46.9%, p<0.001). Progression free survival between the second and the third therapy line was significantly shorter in patients with CK (2.5 months vs. 28.5 and 8 months, p<0.034). The overall survival was 41 (16-80) months and the lethal outcome was present in 53 patients, although no statistically significant difference between patients with different number of aberrations was observed. Summary/Conclusion: In patients with CLL and CK, del17p was present more often, which confirms the existence of genomic instability. Our study showed that patients with CLL and CK more often exhibit peripheral and intra-abdominal lymphadenopathy, with significantly larger diameters of the lymph nodes. However, the association between CK and shorter survival was not established, which confirms the need for further studies on this subject. Keywords: Chromosomal abnormality, Chronic lymphocytic leukemia, Complex aberrant karyotype, Cytogenetics